Gait in patients with adolescent idiopathic scoliosis. Effect of surgery at 10 years of follow-up.

Abstract:

PURPOSE:To assess radiological and gait biomechanical changes before, at one and 10 years after surgery in AIS patients. METHODS:This clinical prospective study included fifteen adult women (mean[SD] age: 26 [1] years) diagnosed with thoraco-lumbar/lumbar AIS and operated 10 years ago. Clinical, radiological and gait variables, including kinematics, electromyography (EMG), mechanics and energetics were compared between presurgery (S0), 1 year (S1) and 10 years (S2) postsurgery period using a one way repeated measure ANOVA. RESULTS:The Cobb angle of the scoliosis curve was reduced by 55% at 1 year postsugery but only by 37% at 10 years postsurgery suggesting a loss of 32% over time. Frontal plumb line C7-S1 distance was significantly improved by surgery (-44%) and remained stable at 10 years postsurgery. Lower limb kinematics was not affected by the surgery at long term. Excessive bilateral activation of lombo-pelvic muscles, observed before surgery, decreased significantly at S1 and S2 period. Mechanical energy increased significantly between S0, S1 and S2 session, without any change for the energetic variables. CONCLUSIONS:Between 1 and 10 years post-surgery, thoraco-lumbar/lumbar AIS women showed a few decompensation of the curve without any change of the improved frontal body balance. Lower limbs and pelvic motion, during gait, was not affected by the surgery. But presurgical excessive EMG activity of the lumbo-pelvic muscle and reduced mechanical energy produced to walk get similar to normal patterns. Only the oxygen consumption remained excessive probably due to physical deconditioning or postural instability.

journal_name

Gait Posture

journal_title

Gait & posture

authors

Mahaudens P,Dalemans F,Banse X,Mousny M,Cartiaux O,Detrembleur C

doi

10.1016/j.gaitpost.2018.01.007

subject

Has Abstract

pub_date

2018-03-01 00:00:00

pages

141-148

eissn

0966-6362

issn

1879-2219

pii

S0966-6362(18)30007-9

journal_volume

61

pub_type

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